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Isolated post laparoscopic DIEA injury in bilateral DIEP breast reconstruction
  1. Theodore Paul Pezas,
  2. Samer Saour and
  3. Farida Ali
  1. Department of Plastic Surgery, St George's University Hospital, St George's University Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Theodore Paul Pezas; theodorepezas{at}


Scarring from previous open abdominal surgery in patients undergoing autologous deep inferior epigastric perforator (DIEP) breast reconstruction has been reported to increase overall flap and donor site complication rates. The evidence to date demonstrates that it can be performed safely although with significantly higher postoperative donor site morbidity. It would seem logical that minimal access laparoscopic surgery is less likely to be associated with increased risks to flap vascularity or donor-site complications; however, there is little evidence available in the literature about the impact of previous laparoscopic surgery to the DIEP harvest site. The typical positions for port placement in standard laparoscopic procedures are usually distant from ideal perforator locations reducing the risk of perforator damage. We present a case of unilateral isolated injury to the proximal deep inferior epigastric artery (DIEA) following previous laparoscopic abdominal surgery in a patient undergoing bilateral mastectomy and breast reconstruction with bilateral free DIEP flaps.

  • Plastic and reconstructive surgery
  • Breast surgery

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  • Contributors TPP wrote the manuscript under the supervision of senior author FA. SS provided some of the photography for the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.